Measurements of nutritional status and impact of malnutrition in polytrauma patients

Verheul, E.A.H. (2025)

Doctoral Thesis

This thesis demonstrates that 18% of polytrauma patients are classified as high nutritional risk, based on the mNUTRIC score at hospital admission, and these
patients face a greater likelihood of developing complications during their hospital stay. In addition, 50% of severely injured patients developed SGA-diagnosed
malnutrition during ICU admission, increasing to 70% during hospital admission. Furthermore, the SGA score is found to be related to complications in polytrauma
patients. For future research, the GLIM diagnostic criteria may provide a more appropriate method for assessing nutritional status in this patient population. Several interventions have been suggested to address the findings from mNUTRIC and SGA assessments in polytrauma patients admitted to the ICU.
The second part of this thesis explored the search for objective markers of nutritional status in polytrauma patients. While certain small metabolites and lipoproteins
show potential for nutritional screening and assessment, further research is necessary before they can be integrated into clinical practice. Fat-soluble vitamins do not appear to be valuable for evaluating nutritional status, and although multivitamin supplementation during ICU admission seems appropriate for polytrauma patients, this study did not demonstrate its effectiveness in preventing complications.
Nutritional assessment can be enhanced using CT-BCPs, especially given the rising prevalence of (sarcopenic) obesity, which necessitates new approaches for assessing body composition. Understanding the impact of malnutrition on polytrauma patients, conducting objective nutritional assessments, and implementing proactive nutritional strategies are crucial for optimizing clinical
outcomes in this population.

• Trauma
• Malnutrition
• Nutritional status
• Complications
• Metabolites
• Lipoproteins
• Vitamins
• Body composition parameters
• Nutritional assessment
• Biomarkers

• All authors: Verheul, E.A.H.
• Supervisor: Schipper, I.B.
• Co-supervisor: Dijkink, S.; Krijnen, P.
• Committee: Arbous, M.S.; Pijl, H.; Verhofstad, M.; Hoogendoorn, J.M.
• Qualification: Doctor (dr.)
• Awarding Institution: Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
• Date: 2025-10-28
• Sponsorship: Nutricia; VoedingOnline; Netwerk Acute Zorg West; Universiteit Leiden